| Study | Reason for exclusion |
|---|---|
| Abdelkefi 2005 | An RCT of low‐dose heparin prophylaxis not antibiotic prophylaxis to reduce non‐tunnelled CVC‐related infections in haemato‐oncological disease |
| Akyuz 2012 | RCT of taurolidine lock solution versus heparin lock solution in children undergoing treatment for cancer. This study did not specifically include patients with newly inserted TCVCs |
| Al Sibai 1987 | 146 patients with malignant disease received 160 Hickman catheters. 70 of these patients received prophylactic antibiotics during and after insertion of the catheter. The catheter infection rate dropped from 0.5‐0.25 per 100 days. Excluded because the antibiotic use and duration were at the discretion of the attending physician, and the results were retrospectively analysed |
| Carratala 1999 | Adult haematology patients with non‐tunnelled CVC's received 10 U heparin per ml (N = 57) or 10 U heparin + 25 µg vancomycin per ml (N = 60) allowed to dwell in catheter 1 hour every 2 days. Catheter‐related bacteraemia in 7% of people in control group and 0% in experimental group (P = 0.05). Mainly excluded because non‐tunnelled catheters |
| Chambers 2005 | RCT of sustained release chlorhexidine dressings (not antibiotics) versus standard dressings for TCVCs in neutropenic people |
| Chatzinikolaou 2003a | Prospective cohort study. M‐EDTA was used as lock solution in indwelling ports in 14 children. No catheter‐related infections were observed. In 48 control participants locked with heparin 10 port infections were observed. Not included because cohort study |
| Chatzinikolaou 2003b | Haemodialysis catheters in people with cancer. 66 people impregnated catheters with minocycline and rifampin and 64 non‐impregnated catheters. 0 catheter‐related infections in the impregnated group and 7 in the non‐impregnated group, duration catheter 8 days. Excluded because this concerns non‐tunnelled catheters and the duration of insertion was short |
| Dawson 2000 | 143 paediatric oncology patients, with 176 TCVC. Intervention cephalothin 100 mg/kg iv or vancomycin 20‐25 mg/kg iv prior to insertion of the catheter. Rate of infections <30 days dropped 40%. No randomisation performed and intervention period was compared to pre‐intervention period |
| Dumichen 2012 | RCT of taurolidine citrate versus heparin as a catheter lock solution in 71 paediatric oncology patients. The lock solution was not used immediately after TCVC insertion in most participants (given up to 2 months after insertion in some cases) |
| Ferreira Chacon 2011 | RCT of minocycline/EDTA versus heparin lock solution in children with TCVCs for chemotherapy, however TCVCs were not newly placed |
| Fourcade 2001 | Prospective cohort study using antibiotic lock technique to prevent bacteraemia in chronic haemodialysis catheters. The incidence of bacteraemia dropped from 4.6 per 1000 catheter days to 0.88 per 1000 catheter days. Not RCT, comparison with historical control, non‐tunnelled catheters |
| Garland 2005 | Prospective RCT in critically ill neonates. Vanco lock solution was used in 42 infants and heparin lock in 43 infants. Two people in the vanco/heparin lock group developed a catheter‐related infection, 13 people in the control group developed a catheter‐related infection, RR 0.13 (95% CI 0.01 to 0.57) highly significant, duration catheter 20 days. Excluded because it concerns non‐tunnelled catheters and done in neonates, which is not the appropriate group for our inclusion criteria |
| Hanna 2004 | Prospective RCT at MD Anderson in cancer patients, 356 catheters placed, 182 impregnated with minocyclin and rifampin, 174 non‐impregnated. Mean duration of the catheter 66 days. Three catheter‐related infections in the MR group and 14 in the non‐impregnated group, highly significant. Not included because these are non‐tunnelled catheters and baseline risk for these catheters is higher than the tunnelled catheters. Also, we included studies of newly inserted tunnelled central venous catheters only |
| Hitz 2012 | RCT of TCVCs coated with athrombogenic coating versus no coating in cancer patients, not an RCT of prophylactic antibiotics |
| Jaeger 2005 | RCT of chlorhexidine/sulfadiazine impregnated CVCs versus standard CVCs in leukaemia patients. This study did not use tunnelled catheters |
| Ocete 1998 | Single‐centre trial; 2 groups control group ‐ 61 newborns and experimental group 85 newborns, all receiving a central catheter (umbilical artery, umbilical vein and/or silastic). The study group received prophylactic vancomycin 25 ug/ml. All participants received parenteral nutrition. Results CNS 21/61 in the control group and 19/85 in the vancomycin group (P < 0.05). The patient group is not the group studied in this review. Methods of the study poor. Not specified how often the prophylactic vanco was given. Clinical criteria were used to determine if the neonate was infected, and then peripheral and central cultures were done. Not specified if quantitative or qualitative cultures were done. Trial not blinded, no tunnelled catheters used, inappropriate patient group |
| Raad 1998 | Crossover study: 26 people with melanoma on IL2 treatment enrolled. All people received a double lumen non‐tunnelled silicone catheter in subclavian vein. People randomised to receive prophylactic antibiotics novobiocin 500 mg + rifampin 300 mg orally. Significant results 41% in control group catheter‐related bacteraemia and 6% in experimental group, excluded because of non‐tunnelled catheters. Very specific group with high incidence of infection, not representative of the participant group for this Cochrane review |
| Raad 2005 | RCT evaluating dalbavancin versus vancomycin for the treatment of adults with CRBSIs |
| Rubie 1995 | 163 paediatric patients with cancer had 180 subcutaneous ports inserted. Over time a change of policy was made from only flushing with heparin to a V/H solution. The infection rate dropped from 31% to 4%. This study was not randomised and the results were retrospectively analysed |
| Scaife 2010 | A retrospective study of perioperative antibiotic prophylaxis for TCVCs implanted to facilitate chemotherapy in adults |
| Schierholz 2010 | RCT evaluating an antibiotic‐releasing CVC (rifampicin‐miconazole) versus a standard CVC in adults (38% with cancer). Non‐tunnelled CVCs were compared |
| Simon 2008 | Not a RCT. A prospective cohort study of heparin versus taurolidine lock solution in 188 adults receiving chemotherapy for cancer. The taurolidine lock solution significantly reduced the rate of CRBSIs |
CRS = catheter‐related sepsis; BMT = bone marrow transplant; TCVC = tunnelled central venous catheter; TPN = total parenteral nutrition; CVC = central venous catheter; TID = totally implantable device; CRBSI = catheter‐related blood stream infection